Jagiellonian University Medical College, Krakow, Poland.
Eur J Pediatr. 2012 Jan;171(1):151-8. doi: 10.1007/s00431-011-1507-5. Epub 2011 Jun 10.
The main goal of the study was to assess the effect of exclusive breastfeeding on the neurodevelopment of children over a 7-year follow-up period and to test the hypothesis that the observed cognitive gain in breastfed children in the first years of life is a strong predictor of their cognitive development trajectory, which may be continued in later life. The analysis is based on data from the 7-year follow-up of 468 term babies (>36 weeks of gestation) born to non-smoking mothers participating in an ongoing prospective cohort study. The cognitive function of children was assessed by psychometric tests performed five times at regular intervals from infancy through the preschool age. The study included valid neurodevelopmental assessment of the children-443 participants were evaluated least twice; 425, three times; and 307, five times in the follow-up period. The association between the cognitive achievements of preschool age children and exclusive breastfeeding of various durations was performed using the generalized estimating equation longitudinal model, adjusted for major confounders such as maternal education, gender, parity, and weight gain in pregnancy. Children breastfed exclusively for up to 3 months had intelligence quotients (IQs) that were on average 2.1 points higher compared to the others (95% confidence interval (CI), 0.24-3.9); children breastfed for 4-6 months scored higher by 2.6 points (95% CI, 0.87-4.27); and the benefit for children breastfed even longer (>6 months) increased by 3.8 points (95% CI, 2.11-5.45). Other predictors were maternal education, gender of the child, having an older sibling, and weight gain during pregnancy. The results of the study support the WHO expert recommendations on exclusive breastfeeding for 6 months; moreover, they provide evidence that even a shorter duration of exclusive breastfeeding in early infancy produces beneficial effects on the cognitive development of children. The breastfeeding-related IQ gain observed already at the age of 1 was sustained through preschool age, and the difference in terms of IQ score between breastfed children and the reference group (mixed breastfeeding) held constant over the whole preschool period.
本研究的主要目的是评估纯母乳喂养对儿童在 7 年随访期间神经发育的影响，并检验以下假设，即在生命最初几年母乳喂养儿童观察到的认知增益是其认知发展轨迹的有力预测指标，这种轨迹可能会延续到以后的生活。该分析基于参加一项正在进行的前瞻性队列研究的不吸烟母亲所生的 468 名足月婴儿（>36 周妊娠）7 年随访的数据。通过对婴儿期至学龄前定期进行的心理测试评估儿童的认知功能。该研究包括对儿童进行有效的神经发育评估——443 名参与者至少评估了两次；425 名参与者评估了三次；307 名参与者评估了五次。使用广义估计方程纵向模型，根据母亲教育、性别、胎次和孕期体重增加等主要混杂因素，对学龄前儿童的认知成绩与不同持续时间的纯母乳喂养之间的关联进行了分析。与其他儿童相比，纯母乳喂养时长不超过 3 个月的儿童的智商（IQ）平均高出 2.1 分（95%置信区间（CI）：0.24-3.9）；纯母乳喂养 4-6 个月的儿童高出 2.6 分（95% CI：0.87-4.27）；纯母乳喂养时间更长（>6 个月）的儿童获益增加 3.8 分（95% CI：2.11-5.45）。其他预测因素包括母亲教育、儿童性别、是否有兄弟姐妹、孕期体重增加。该研究结果支持世界卫生组织关于纯母乳喂养 6 个月的专家建议；此外，该研究结果还提供了证据，表明即使在生命最初几个月内进行更短时间的纯母乳喂养，也会对儿童的认知发育产生有益影响。在 1 岁时观察到的与母乳喂养相关的智商增益一直持续到学龄前，在整个学龄前期间，母乳喂养儿童与参照组（混合喂养）的智商得分差异保持不变。
